Update in Nutrition and Functional Medicine M E R I N K I N I K I N I, D N P, F N P, R D, C N S C, I F M S E M P T E M B E R 1 4-15 TH 2 0 1 7 M E R I N. K I N I K I N I @ I M A I L. O R G
Objectives Give you an overview of functional medicine as it applies to health and disease. Discuss leaky gut and SIBO Discuss the 5 R s of gut health Give functional nutrition resources for patients with chronic disease.
All slides have been reprinted with permission from IFM and other sources
80% chronic disease is from environment, not genetics!
Zonulin plays a big role in opening the tight junctions in the intestine
Any patient who is having GI issues, who has an autoimmune condition (and/or family history of autoimmune), and other s/s chronic disease that could be from leaky gut should not be eating GLUTEN.
We are what we eat. And absorb and Assimilate!
Elemental Diet Elemental diets may be an extremely safe and effective alternative to antibiotics. These formulations are believed to be absorbed within the first few feet of small bowel and potentially limiting the delivery of nutrients to the bacteria residing in distal portion of small bowel. 124 patients given Vivonex. If breath test did not normalize by week 2, patients continued the diet for a total of 3 weeks. By day 15, 80% of subjects normalized their breath test. Curr Gastroenterol Rep (2016) 18:8
SIBO is a complicated condition that can often times take months to treat. Diet continues to be the cornerstone of therapy, with the addition of selected antibiotics and herbal therapies along the way. If you don t identify and treat the CAUSE, then the SIBO will continue to recur
Elimination Diet (leaky gut, general GI) R E M O V E S T O P O F F E N D E R S S U C H A S S O Y, D A I R Y, G L U T E N, E G G S, S H E L L F I S H, P E A N U T S, C O R N A N D S O M E T I M E S N I G H T S H A D E S. R E M O V E S A L L T H E C R A P P R O C E S S E D F O O D S, S O D A, E T O H, C A F F E I N E E T C. U S U A L L Y O N F O R A T L E A S T 4-6 W E E K S
Modified FODMAP (suspected SIBO, IBS) F R U C T O S E ( W H E N I N E X C E S S O F G L U C O S E ), F R U C T A N S, G A L A C T O - O L I G O S A C C H A R I D E S ( G O S ), L A C T O S E A N D P O L Y O L S ( EG. S O R B I T O L A N D M A N N I T O L ). G E N E R A L L Y L O W E R I N S U G A R
September LIVE GDX Webinar Supporting Gut Barrier Function Thomas Guilliams, PhD September 27, 2017 12 PM EDT Rebroadcast September 28, 2017 7 PM EDT
Most Important Replacement VEGETABLES! ½ plate, 9+ servings Different groups and colors of the rainbow Modified forms if needed (whipped, roasted, blenderized) Free of pesticides (dirty dozen and clean 15)
Using Products Starting with the mouth and upper GI tract If no documented ulcer, safe to try either apple cider vinegar (1 T.) or 1-2 capsules of betaine with meals. If you feel a warm sensation w the betaine, decrease by one capsule. This helps assure there is enough acid present to break down the protein. Use digestive enzymes 2-4 with meals to help break down the fibers and proteins from your meal and utilize them more efficiently. People with poor digestion may want to try these products
PROBIOTICS Usually suggest multi-strain and 50-100 billion/day trial for 4-6 weeks. (based on expert opinion and data from IBD trials)
FERMENTED FOODS
Repair Supply zinc, antioxidants (like vitamin A, C and E), vitamin D, fish oil, and glutamine. Avoid triggers to cause leaky gut again sugar, processed foods, and in some people wheat and dairy.
Rebalance Role of stress on overall health Meditation Relaxation Removing toxic relationships Sleep
Most Important Thing to Do for Your Patients. G E T T H E M O F F S A D A N D E A T V E G E T A B L E S!! I F W I L L I N G, A N D H A V E M O N E T A R Y R E S O U R C E S G E T T H E M F U R T H E R T E S T I N G. ( S T O O L T E S T, N U T R E V A L, F O O D I G G T E S T I N G. U S E A L L T H E T O O L S T O A S S U R E F O O D I S D I G E S T E D P R O P E R L Y ( E N Z Y M E S, B E T A I N E E T C. ) H A V E T H E M E A T A S C L E A N A S P O S S I B L E. ( P E S T I C I D E S, P L A S T I C S E T C. ) M O S T P E O P L E N E E D A D D I T I O N A L A N T I O X I D A N T A N D V I T A M I N S U P P O R T. S O M E W I L L N E E D A N T I B I O T I C S E T C. M A K E S U R E T H E Y A R E R E L I E V I N G S T R E S S A N D H A V E P A T I E N C E!
ADDITIONAL RESOURCES
The End